BILL PURPOSE: To provide appropriations for four
of the 13 regular appropriation bills
and other miscellaneous appropriations. The Act also includes several authorization
bills.

OMB ESTIMATE:

(Fiscal years; in millions of
dollars)

2000

2001

2002

2003

2004

2005

Direct spending:

Medicare........................................

0

5,080

7,935

6,460

7,250

8,360

Medicaid, SCHIP and other health.

0

995

1,520

690

390

220

Other..............................................

0

399

261

266

236

222

Receipts:

Community renewal tax relief.......

0

-248

-1,074

-1,815

-1,930

-2,235

Civil service retirement roll back..

0

-427

-619

-160

0

0

Other.............................................

0

-21

-101

-160

-189

-200

Net costs............................................

0

7,170

11,510

9,551

9,995

11,237

Not subject to pay-as-you-go:

Off-budget outlays.......................

0

691

409

412

414

411

Off-budget receipts.......................

0

0

0

0

0

0

Net costs..................................

0

691

409

412

414

411

Although P.L. 106-554 is an appropriations Act, it includes language directing OMB to
score certain sections as subject to pay-as-you-go requirements, rather than as
discretionary. It also directs OMB to change the pay-as-you-go scorecard for FY 2001 to
zero in the final sequestration report. The table above shows the costs that are subject to
pay-as-you-go pursuant to this Act and the off-budget costs that are exempt from pay-as-you-go
procedures.

OMB estimates that P.L. 106-554 will increase net pay-as-you-go costs by $49.5 billion
over the 2001-2005 period. The Medicare, Medicaid, and SCHIP Benefits Improvement
and Protection Act is estimated to increase net direct spending by $38.9 billion over the
five-year period. In addition, community revitalization and other provisions in the
Community Renewal Tax Relief Act are estimated to result in revenue losses of $7.3
billion over the five years. The remaining net costs result largely from roll back of
Federal employee retirement contributions, increased benefits to compensate for an error
in the Consumer Price Index, and increases in maximum percentage contribution
limitations to the Federal Thrift Savings program.

CBO ESTIMATE:

(Fiscal years; in millions of dollars)

2000

2001

2002

2003

2004

2005

Direct spending:

Medicare........................................

0

3,908

7,981

6,331

6,639

7,414

Medicaid, SCHIP and other health.

0

31

-755

-3,327

-5,069

-6,181

Other..............................................

0

541

347

292

318

332

Receipts:

Community renewal tax relief.......

0

-120

-999

-1,949

-2,104

-2,365

Civil service retirement roll back..

0

0

0

0

0

0

Other.............................................

0

-16

-78

-129

-170

-208

Net costs............................................

0

4,616

8,650

5,374

4,162

4,138

Not subject to pay-as-you-go:

Off-budget outlays.......................

0

720

410

400

390

380

Off-budget receipts.......................

0

1

1

1

-2

0

Net costs..................................

0

719

409

399

392

380

EXPLANATION OF DIFFERENCES BETWEEN OMB AND CBO ESTIMATES:

Over the 2001-2005 period, CBO scores net costs of $26.9 billion, while OMB scores net
costs of $49.5 billion. The difference of $22.5 billion is primarily the result of scoring
differences for the Medicaid and Medicare provisions. CBO's scoring of net impact for
the Medicaid, SCHIP, and other health provisions is $19.1 billion below OMB, largely
due to different estimates for the provision requiring the Department of Health and
Human Services (HHS) to publish a regulation curbing States' inappropriate use of
provider upper payment limits (UPL) under the Medicaid program. CBO assumes higher
State UPL spending in its baseline than OMB does. As a result, CBO estimates higher
savings from the provision directing HHS to issue a regulation that would curb the
inappropriate State practices. For the Medicare provisions, CBO scores $2.8 billion
lower net costs than OMB due to different baseline assumptions and different technical
estimates for several provisions. In addition, CBO scored costs of $1.3 billion for roll
back of Federal employee retirement contributions to the Transportation Appropriations
Act. OMB scores costs of $1.2 billion for that provision to this Act as directed.